list of all types of vegetables

Document Sample
list of all types of vegetables Powered By Docstoc
					Modified child nutrition questionnaire




               Nutrition Questionnaire for students in Years 5, 6, 7




  This questionnaire asks about what you eat and drink. It starts with some general
  questions about what you think about fruit and vegetables and then about what you
  eat and drink at different times.

  The teacher and classroom helpers will help you fill out this questionnaire.

  The information will be used to describe all of the children in years 5, 6 & 7 as a group.
  Your individual information will be kept private and confidential.




        Implemented by Southern Primary Health of Southern Adelaide Health Service and Murray
        Mallee Community Health Service
                                                                               Reference Number
                                                                               -
Your Name___________________________________________________________________________

Year level (for example yr 6) _________________________________________________________

                                      What you usually eat and drink
1. Think about today. Describe what you drink at each time?
Tick as many boxes as apply
Drinks you will have/have had today at:                      Recess    Lunch     After school (not
                                                                                 including dinner)
                                                                1        2               3
a. Nothing to drink
b. Cordial
c. Fruit Juice or fruit juice drink
d. Regular Soft Drink or Energy/Sports
   Drink (eg. Powerade)
e. Diet Soft Drink (eg Coke Zero, Diet Fanta)
f.   Water
g. Milk/flavoured milk

2. Think about today. Describe what you eat at each time?
Tick as many boxes as apply
Foods you will have/have eaten today at:                     Recess    Lunch      After school (not
                                                                                  including dinner)
                                                               1         2                3
a. Nothing to eat
b. Potato crisps or similar snack (eg twisties)
c. Chocolate/Chocolate bar
d. Lollies
e. Muesli bar/ fruit bar
f.   Yoghurt / custard
g. Savoury biscuits (eg saladas, jatz & dip)
h. Sweet biscuits/Cake/Muffin/Doughnut
i.   Icecream/Iceblock
j.   Vegetables or salad
k. Fruit (fresh or canned)
l.   Dried fruit (eg sultanas)
m. Hot chips/French fries/wedges
n. Pie/Pastie/Sausage roll
o. Hot dog
p. Pizza
q. Sandwich/roll
r.   Bread/toast
s. Spaghetti/pasta/noodles/rice
t.   Soup

Nutrition Questionnaire for Students in Years 5,6,7 - 2006                             2 of 8
3. In the class room, how often do you have a ‘fruit and/or vegetable break’?
Tick one box
Never/rarely                 Once/week               Most days/week        Every day
       1                            2                        3                  4




4. In class time, do you usually have a drink on your desk?
Tick one box
           1.    Not allowed
           2.    No, even though it is allowed
           3.    Yes - If yes, what do you usually drink? ________________

5. How often do you usually do the following?
Tick one box in each row
                                               Never/rarely OR      About 1-3         About 4-6    Every
                                            Less than once/week   times/week        times/week      day

                                                         1             2                 3            4
a. Drink water
b. Drink fruit juice or fruit juice
   drink
c. Drink softdrink (not including
   diet softdrink)

d. Carry a water bottle
e. Eat chocolate or lollies
f.   Eat hot chips/French
     fries/wedges
g. Eat potato crisps or similar
   snack (eg twisties)
i.   Help choose or buy groceries
     for the family
j.   Help prepare your dinner
k. Eat dinner with most of the
   family
l.   Eat dinner in front of the
     television
m. Eat snacks in front of the
   television




Nutrition Questionnaire for Students in Years 5,6,7 - 2006                                        3 of 8
                                          What do you think about

6. How strongly do you agree or disagree with the following statements?

Tick one box in each row
                                                             Strongly   Agree     Not sure   Agree       Strongly
                                                              agree                                      disagree
                                                                1         2          3            4            5
a. Eating vegetables makes me feel
   healthy

b. I like the taste of many vegetables
c. In my home, vegetables are served at
   dinner most nights
d. I like tasting new vegetables that I
   haven’t tried before
e. It is easy to prepare vegetables to eat
   eg make a salad

f.       Eating fruit makes me feel healthy

g. I like the taste of most fruit

h. Fruit is an easy snack
i.       I like tasting new fruits that I haven’t
         tried before
j.       In my home fruit is available to eat at
         any time

l.       I like to drink water
m. I ask my parents to buy foods or drinks
   that I see advertised on television
n. My parents encourage me to eat fruit
   and vegetables
o. Most of my teachers encourage the
   students to eat fruit and vegetables

7. Where did you/will you get your recess from today?
Tick one box
Home         Canteen                  Shop outside of school            Friends       No recess today
     1                  2                           3                     4                   5




8. Where did you/will you get your lunch from today?
Tick one box
Home         Canteen                  Shop outside of school            Friends       No lunch today
     1                   2                          3                     4                   5




Nutrition Questionnaire for Students in Years 5,6,7 - 2006                                            4 of 8
                                   About fruit and vegetables you eat

9. How many serves of vegetables do you usually eat each day?
   (1 serve = 1 cup of salad vegetables, OR ½ a cup of cooked vegetables, OR 1 medium
   potato)
    Tick one box
        1.    I don’t eat vegetables
        2.       Less than 1 serve a day
        3.       1-2 serves a day
        4.       3-5 serves a day
        5.       More than 5 serves a day


10. How many serves of fruit do you usually eat each day?
    (1 serve = 1 medium piece, OR 2 small pieces of fruit eg mandarins or apricots, OR 1
    cup of diced pieces)
    Tick one box
        1.    I don’t eat vegetables
        2.        Less than 1 serve a day
        3.       1-2 serves a day
        4.       3-5 serves a day
        5.       More than 5 serves a day




Nutrition Questionnaire for Students in Years 5,6,7 - 2006                          5 of 8
11. Below is a list of different types of fruits (fresh, canned or dried). For each fruit please
    indicate answer PART A and PART B.
     PART A:     Please indicate if you ate this fruit yesterday, by ticking the box that applies
                 to you, for each fruit
     PART B:     Please indicate if you like this fruit by ticking the box that applies to you, for
                 each fruit
Tick one box in each row
                                       PART A                                     PART B
Type of fruit             I ate this fruit    I didn’t eat this    Never had it   Yes I like      No I don’t
                            yesterday         fruit yesterday     or don’t know    this fruit   like this fruit
                                                                     what it is
                                 1                    2                 3             4               5

a. Apple

b. Apricot

c. Banana

d. Grapes

e. Kiwi fruit

f.   Mandarin

g. Nectarine

h. Orange
i.   Peach
j.   Pear

k. Pineapple

l.   Plum

m. Rockmelon

n. Strawberries

o. Watermelon




Nutrition Questionnaire for Students in Years 5,6,7 - 2006                                           6 of 8
12. Below is a list of different types of vegetables (fresh, canned or frozen).
    For each vegetable please answer PART A and PART B
     PART A:     Please indicate if you ate this vegetable yesterday, by ticking the box that
                 applies to you, for each vegetable
     PART B:     Please indicate if you like this vegetable by ticking the box that applies to
                 you, for each vegetable
Tick one box in each row
Type of vegetable                         I ate this vegetable   I didn’t eat this vegetable
                                               yesterday                  yesterday
                                                                              2
                                                    1

a. Beans (green)
b. Beetroot
c. Broccoli
d. Brussel sprouts
e. Cabbage
f.   Capsicum
g. Carrot
h. Cauliflower
i.   Celery
j.   Chinese greens
k. Corn
l.   Cucumber
m. Eggplant
n. Legumes (baked
   beans, chickpeas,
   lentils, kidney beans)
o. Lettuce
p. Mushroom
q. Peas
r.   Pot ato (not hot chips)
s. Potato fried eg hot
   chips/ french
   fries/wedges
t.   Pumpkin
u. Spinach
v. Sweet potato
w. Tomato
x. Zucchini
y. Squash




Nutrition Questionnaire for Students in Years 5,6,7 - 2006                                     7 of 8
                                 Fantastic, you’ve finished
                                       THANK YOU




Nutrition Questionnaire for Students in Years 5,6,7 - 2006     8 of 8

				
DOCUMENT INFO
Shared By:
Stats:
views:6581
posted:3/17/2009
language:English
pages:8